| NPI | 1811500309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 7685284-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p7483) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |