| NPI | 1740617042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 67291) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST019649) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2023-06-08 |