| NPI | 1861152498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 87803) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 125628) |
| 183500000X Pharmacist (Licence: WI 21356-40) | |
| 183500000X Pharmacist (Licence: AZ S026507) | |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2023-11-09 |