| NPI | 1780241604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S023638) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0022519) |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2019-05-27 |