| NPI | 1023993375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh6671) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 18672) |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-08-06 |