| NPI | 1871266460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 30702) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP456090) |
| 183500000X Pharmacist (Licence: SC 43143) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-04-21 |