| NPI | 1497270086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2018015444) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 61060) |
| 183500000X Pharmacist (Licence: IL 051302226) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2024-06-19 |