| NPI | 1972284404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 22418) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 126118) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2024-03-30 |