| NPI | 1265935548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202216755) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 16406) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2022-08-19 |