| NPI | 1013752146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 74151) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202221373) |
| Enumeration Date | 2024-06-29 |
| Last Update Date | 2024-06-29 |