| NPI | 1780309443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63417) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: FL NP534) |
| 183500000X Pharmacist (Licence: GA RPH036018) | |
| 183500000X Pharmacist (Licence: AL 24397) | |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2026-01-02 |