| NPI | 1760095368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 66787) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 41313) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2024-06-18 |