| NPI | 1942707617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 29950) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS58449) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-12-14 |