| NPI | 1043974371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 4350) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 43230) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-09-28 |