| NPI | 1336037977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 102862-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202218790) |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-06-24 |