| NPI | 1023650249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S024755) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 65892) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2024-03-07 |