| NPI | 1164168258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 21440) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH033598) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |