| NPI | 1144929993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP458190) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV 0012773) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2024-03-31 |