| NPI | 1013508977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 15343) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 25273) |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-02-02 |