| NPI | 1902579279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD15864) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 69090) |
| Enumeration Date | 2021-07-31 |
| Last Update Date | 2021-08-14 |