| NPI | 1548730724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 0022391) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 66806) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2024-09-11 |