| NPI | 1952800617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202216523) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 41387) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-08 |