| NPI | 1649882911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202217447) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238760) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2025-09-29 |