| NPI | 1730722091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6683586-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 18058) |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2019-10-18 |