| NPI | 1972107852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 26290) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH10003606) |
| 183500000X Pharmacist (Licence: MA PH237541) | |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2026-01-05 |