| NPI | 1518759208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 27209) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 40603) |
| Enumeration Date | 2025-05-20 |
| Last Update Date | 2025-05-20 |