| NPI | 1699125898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202214883) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0011521) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2024-07-09 |