| NPI | 1447194642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 73827) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM rp00009751) |
| Enumeration Date | 2026-04-17 |
| Last Update Date | 2026-04-17 |