| NPI | 1689040479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0020881) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPh5815) |
| Enumeration Date | 2015-08-15 |
| Last Update Date | 2015-08-15 |