| NPI | 1588491963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302416628) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS67728) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2025-01-30 |