| NPI | 1407742661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS66303) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: KY 023870) |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-06-16 |