| NPI | 1891110516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ 016669) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 0020206) |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2022-08-24 |