| NPI | 1023614567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0015381) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH033373) |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2022-12-23 |