| NPI | 1437820818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 022601) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: KY I13788) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2022-02-23 |