| NPI | 1770186884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2019028173) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 16769) |
| 183500000X Pharmacist (Licence: KS 1-105500) | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |