| NPI | 1114811171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP459320) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID 3571778) |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-08-22 |