| NPI | 1215578208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20868) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 12236265-8911) |
| 183500000X Pharmacist (Licence: AZ S024035) | |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2021-09-08 |