| NPI | 1093510018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS63175) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202206191) |
| 183500000X Pharmacist (Licence: CA 56769) | |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-02-14 |