| NPI | 1992307409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: LA PST.021571) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26021014A) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |