| NPI | 1487379947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63952) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 67624) |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |