| NPI | 1679205736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S025850) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 24170) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |