| NPI | 1548752421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 20315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 4046) |
| 183500000X Pharmacist (Licence: ID P8007) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2024-07-30 |