| NPI | 1285509406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 25168) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH997056) |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |