| NPI | 1730736190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 7430082) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 0021737) |
| 183500000X Pharmacist (Licence: ID p8372) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |