| NPI | 1770461469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0207X Pharmacist, Compounded Sterile Preparations (Licence: FL PS53750) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0013583) |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |