| NPI | 1922483114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0024767) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18931) |
| 183500000X Pharmacist (Licence: PA RP449769) | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2024-07-22 |