| NPI | 1093492340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS58955) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH033511) |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2025-01-29 |