| NPI | 1679284558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 7047) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PR 7047) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2025-11-12 |