| NPI | 1689545832 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 34885) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.025953) |
| Enumeration Date | 2025-09-12 |
| Last Update Date | 2026-08-31 |