| NPI | 1245116292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 025336) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH035587) |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-08-14 |