| NPI | 1558248310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH239993) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 23811) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |