| NPI | 1891347043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP453323) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202218628) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2024-08-29 |