| NPI | 1003530080 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR 12210) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051296257) |
| 183500000X Pharmacist (Licence: OK 17155) | |
| 183500000X Pharmacist (Licence: TX 68386) | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |