| NPI | 1083170153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 18552-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-106867) |
| 183500000X Pharmacist (Licence: MO 2019014830) | |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2022-05-06 |