| NPI | 1578442232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS39238) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0005217) |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |