| NPI | 1003491275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV NV13567) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 13567) |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-03-10 |