| NPI | 1114279254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS P12649) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 32786) |
| 183500000X Pharmacist (Licence: NC 2016003813) | |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2026-06-08 |