| NPI | 1891277505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 36053) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25012) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |