| NPI | 1952077919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9551) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 6874) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |