| NPI | 1689142077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 202214040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25107) |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |