| NPI | 1912488255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 124387) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS57786) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2023-07-25 |