| NPI | 1740783786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 39476) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202214809) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |