| NPI | 1508017799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 27576) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS0032550) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2026-05-25 |