| NPI | 1023898921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P11072) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 98673) |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2025-08-01 |