| NPI | 1265818272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35589) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH200005273) |
| 183500000X Pharmacist (Licence: FL PS55438) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2026-06-25 |