| NPI | 1215517065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 115379) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 10900) |
| 183500000X Pharmacist (Licence: AZ 8784) | |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-04-14 |