| NPI | 1225850134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 25077) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 22035-40) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |