| NPI | 1922620491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3036) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH23396) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |