| NPI | 1093471567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S025598) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS63736) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2024-07-01 |