| NPI | 1063352490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SD 7265) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPh6657) |
| Enumeration Date | 2026-03-28 |
| Last Update Date | 2026-03-28 |