| NPI | 1710658943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 31230) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.024065) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2022-07-26 |