| NPI | 1003411695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 15576) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH023548) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-11-01 |