| NPI | 1477428811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0011342) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH241304) |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |