| NPI | 1851976617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 3316) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP040095L) |
| 183500000X Pharmacist (Licence: FL PS29422) | |
| 183500000X Pharmacist (Licence: CO 14551) | |
| 183500000X Pharmacist (Licence: AZ S016833) | |
| Enumeration Date | 2021-03-13 |
| Last Update Date | 2021-03-13 |