| NPI | 1598642373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID 5271973) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 127072) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |