| NPI | 1740889104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202217101) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100003835) |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2020-10-18 |