| NPI | 1003045568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 40683) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 118114) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2025-07-16 |