| NPI | 1194407544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2023022647) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P10095) |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |