| NPI | 1043846819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS60360) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PH16249) |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2022-12-20 |