| NPI | 1225775224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VT 033.0132482) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH234265) |
| 183500000X Pharmacist (Licence: NH R2510) | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-05-31 |