| NPI | 1871182709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT0008620) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH19367) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-01-14 |