| NPI | 1447686514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52992) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.025790) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2025-09-24 |