| NPI | 1124627401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-71393) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8966) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2023-01-27 |