| NPI | 1194435529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 121712) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS34868) |
| 183500000X Pharmacist (Licence: MI 5302413325) | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |