| NPI | 1831702877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 63942) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH031294) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2022-12-21 |