| NPI | 1801344478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT11375) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH235778) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |