| NPI | 1568139590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63229) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP456018) |
| 183500000X Pharmacist (Licence: ID P9792) | |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-12-17 |