| NPI | 1932744646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 14479) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 47357) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2019-11-18 |