| NPI | 1912539925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0134311) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR69517) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |