| NPI | 1306613492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202221721) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID p11027) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2023-12-07 |