| NPI | 1134972219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD16636) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 17968) |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2025-11-20 |