| NPI | 1871089458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 17217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ 8629) |
| 183500000X Pharmacist (Licence: CO 14697) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2018-07-06 |