| NPI | 1841290459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36444) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 114818-1) |
| 183500000X Pharmacist (Licence: IA 17548) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2026-07-13 |