| NPI | 1619563681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 45964) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 17646-40) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2025-10-02 |