| NPI | 1578111050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S026852) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0013712) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2024-07-11 |