| NPI | 1891343968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 32562) |
| Additional Taxonomies | 1835N0905X Pharmacist Nuclear (Licence: TX 32562) |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2019-08-30 |