| NPI | 1558080184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S026432) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP457054) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2026-05-18 |