| NPI | 1073374302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 23017-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2024000997) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2025-08-03 |