| NPI | 1144093733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0025036) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 22427-40) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2025-03-05 |