| NPI | 1629408869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302036325) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS48725) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2026-03-13 |