| NPI | 1063238368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 243267) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: AK 218372) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2025-08-07 |