| NPI | 1346929320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 23475) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 9765691-1701) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |