| NPI | 1730694621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P7861) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0017771) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2022-12-20 |