| NPI | 1740914183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 109613) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 234233) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-03-27 |