| NPI | 1801565783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63198) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP456686) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2022-05-19 |