| NPI | 1609558410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh6505) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 126250) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-09-30 |