| NPI | 1811495757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 38323) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2017028107) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |