| NPI | 1780296889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 122687) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPh6193) |
| 183500000X Pharmacist (Licence: CO 0022993) | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |