| NPI | 1568831881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 8418441-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S021544) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2026-05-15 |