| NPI | 1033718911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP454631) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 6808) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-12-08 |