| NPI | 1699379685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS60446) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH28597) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |