| NPI | 1982460523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 21263-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302048478) |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |