| NPI | 1194457432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 67174) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-100854) |
| 183500000X Pharmacist (Licence: MO 2020024561) | |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |