| NPI | 1992469589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 11962949-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 41502) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |