| NPI | 1659249811 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh5790) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122412) |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |