| NPI | 1780396358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302414941) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5315237757) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2024-06-30 |