| NPI | 1093231896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 27610) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 37167) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2024-12-27 |