| NPI | 1104422922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME 71408) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 236739) |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2023-06-20 |