| NPI | 1376982090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2015036083) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-117634) |
| 183500000X Pharmacist (Licence: IL 051301885) | |
| 183500000X Pharmacist (Licence: VA 0202211411) | |
| Enumeration Date | 2013-06-15 |
| Last Update Date | 2022-09-26 |