| NPI | 1811657489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 041757) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 11562) |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2021-12-31 |