| NPI | 1407674450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH1000967) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH1000) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |