| NPI | 1457132888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 23192) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 126302) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2025-11-11 |