| NPI | 1386505972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0016724) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 11457) |
| Enumeration Date | 2025-11-21 |
| Last Update Date | 2025-11-21 |