| NPI | 1922619113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 42534) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 022743) |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |