| NPI | 1073117818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH023885) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18179) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2020-11-23 |