| NPI | 1538899943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 023908) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 46179) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2024-04-09 |