| NPI | 1700557311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GU ph0215) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME pr4653) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-09-23 |