| NPI | 1770274110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP458318) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 204266) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2024-07-11 |