| NPI | 1184304347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P10652) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238571) |
| 183500000X Pharmacist (Licence: WA PH61526496) | |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-05-30 |