| NPI | 1922651181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P8080) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0024243) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2025-04-21 |