| NPI | 1902096605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 009856) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: TN 5822) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2025-07-28 |