| NPI | 1811564982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S020393) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007821) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-08 |