| NPI | 1144817065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202219167) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0012473) |
| Enumeration Date | 2020-12-26 |
| Last Update Date | 2023-09-06 |