| NPI | 1033436241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 010375) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 12589) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2022-12-20 |