| NPI | 1841738689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.021903) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 76231) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2026-06-28 |