| NPI | 1821078288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 20434) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 010410) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2022-03-19 |