| NPI | 1215350855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS19355) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 10215) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2025-01-25 |