| NPI | 1811608524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.0015253) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 46821) |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2022-12-13 |