| NPI | 1245108125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18776) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP0007095) |
| 183500000X Pharmacist (Licence: FL PS26764) | |
| Enumeration Date | 2025-10-23 |
| Last Update Date | 2025-10-23 |