| NPI | 1801507082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 22081) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2014031543) |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2023-01-06 |