| NPI | 1235760018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR72077) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 72986) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2024-07-24 |