| NPI | 1437723368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 72710) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: TX 276459) |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2023-07-31 |