| NPI | 1699377994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 66193) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 19184) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2020-11-11 |