| NPI | 1861775918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P7689) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 6224281-1701) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2020-12-10 |