| NPI | 1033832100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-108018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 55790) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |