| NPI | 1265865182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH028309) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P6853) |
| 183500000X Pharmacist (Licence: TN 44875) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2026-07-30 |