| NPI | 1740889922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 84025) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S024983) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-10-19 |