| NPI | 1669081956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-109420) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2021051192) |
| 183500000X Pharmacist (Licence: KY 023980) | |
| 183500000X Pharmacist (Licence: MI 5302415724) | |
| 183500000X Pharmacist (Licence: VA 0202221730) | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2023-12-08 |