| NPI | 1346795044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 36746) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 26258) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2023-04-27 |