| NPI | 1770469363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps69600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID 3271971) |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-09-18 |