| NPI | 1902743966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0009425) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH27434) |
| Enumeration Date | 2026-04-29 |
| Last Update Date | 2026-04-29 |