| NPI | 1790436467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302033521) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5315106785) |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2022-01-14 |