| NPI | 1811491814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 15820) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 23216) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |