| NPI | 1649986738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S026306) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 23326) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |