| NPI | 1093309965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 47660) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0023369) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2026-07-09 |