| NPI | 1184242950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 125402) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 16463) |
| 183500000X Pharmacist (Licence: SD R-6840) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2022-05-03 |