| NPI | 1861909590 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH237044) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0013864) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |