| NPI | 1083133441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P9930) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 19351) |
| 183500000X Pharmacist (Licence: AZ 23822) | |
| 183500000X Pharmacist (Licence: UT 14013445-1701) | |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2026-01-28 |