| NPI | 1689097263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 46768) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps34160) |
| Enumeration Date | 2014-02-01 |
| Last Update Date | 2022-10-19 |