| NPI | 1316540370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0025144) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH239673) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2025-07-21 |