| NPI | 1932839412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 43876) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH033670) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2023-05-18 |