| NPI | 1851010862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 43846) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 31605) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2024-04-10 |