| NPI | 1033074802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: TX 76331) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 76331) |
| Enumeration Date | 2025-12-23 |
| Last Update Date | 2026-07-14 |