| NPI | 1093377756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 124335) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 813517) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2021-09-22 |