| NPI | 1861934051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.019905) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS t-12850) |
| Enumeration Date | 2016-11-06 |
| Last Update Date | 2026-04-09 |