| NPI | 1992478432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202219693) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 30488) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-07-30 |