| NPI | 1952920928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 64384) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH030988) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-11-13 |