| NPI | 1942514641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3694) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR45899) |
| 183500000X Pharmacist (Licence: MA PH235763) | |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2025-11-05 |