| NPI | 1972324424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 5806603-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S018515) |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |