| NPI | 1811592892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202216980) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 26141) |
| 183500000X Pharmacist (Licence: TX 66018) | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2024-01-23 |