| NPI | 1821592650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 42839) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 011385) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2026-02-26 |