| NPI | 1699378919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2019019414) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-107038) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |