| NPI | 1295400927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 0023684) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 4322) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2021-08-13 |