| NPI | 1184237562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 20665-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 20124) |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2023-06-16 |