| NPI | 1033795190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 041030) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-10577) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-03-19 |