| NPI | 1962126615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S025780) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2021031823) |
| 183500000X Pharmacist (Licence: KS 1-103649) | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2023-12-11 |