| NPI | 1619724770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 25531) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH035678) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2026-06-17 |