| NPI | 1982184255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24420) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202215702) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |