| NPI | 1104579994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH033438) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-100481) |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |