| NPI | 1386174035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP449481) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rpi009614) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2026-01-08 |