| NPI | 1558878827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.022336) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 66308) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2026-05-31 |