| NPI | 1851790455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63797) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 121824) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2023-04-04 |