| NPI | 1639555360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 43979) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25358) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2024-08-29 |