| NPI | 1225701261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.025784) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 20853) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-12-13 |