| NPI | 1043781099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 16182) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH030771) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |