| NPI | 1053031278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 199982) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0134736) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-01-04 |