| NPI | 1831605245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202210262) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 19920) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2025-01-25 |