| NPI | 1851963078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS62392) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2019025950) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-07-16 |