| NPI | 1124708417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 23795) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 13452988-1721) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-07-20 |