| NPI | 1962122630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 125866) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 1962122630) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-10-21 |