| NPI | 1720609357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 21319) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 51691) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |