| NPI | 1215658646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2022035198) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-114533) |
| Enumeration Date | 2022-09-05 |
| Last Update Date | 2022-09-05 |