| NPI | 1609535814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 11780) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-07910) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |