| NPI | 1073233607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-125352) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2022035200) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2025-08-05 |