| NPI | 1972494961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 0021920) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 122169) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-07-09 |