| NPI | 1134840473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 9801291-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 9801291-8911) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |