| NPI | 1467722983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2024023164) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps47213) |
| Enumeration Date | 2012-01-02 |
| Last Update Date | 2025-06-12 |