| NPI | 1770194649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 24696) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-109200) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2023-06-10 |