| NPI | 1326642455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH PHCY01445) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2023-03-06 |