| NPI | 1073296737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63339) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-119122) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-01-21 |