| NPI | 1689293631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS56158) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH031898) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-10-15 |