| NPI | 1245840065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9001) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 7788409-1701) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2022-01-08 |