| NPI | 1306525712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 29242) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH241141) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-17 |