| NPI | 1013634385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS55300) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: FL NP461) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |