| NPI | 1780446195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 88110) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID PI0863) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-01-30 |