| NPI | 1093317778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E13993) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 72329) |
| 183500000X Pharmacist (Licence: LA PST.021270) | |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-11-23 |