| NPI | 1205344785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 19793) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 9144749-1701) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2022-12-27 |