| NPI | 1699591966 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 23377) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 22552-40) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |