| NPI | 1255028965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 8058) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH241396) |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-04-21 |