| NPI | 1972487155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP460253) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS69187) |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2026-05-19 |