| NPI | 1265153050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20793) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S025759) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-10-31 |