| NPI | 1508537739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 45400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH033176) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2026-05-11 |