| NPI | 1801743166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 30853) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID 2571598) |
| Enumeration Date | 2026-03-14 |
| Last Update Date | 2026-03-14 |