| NPI | 1760098172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S025208) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 124728) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2023-03-11 |