| NPI | 1114638509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 020326) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302413867) |
| 183500000X Pharmacist (Licence: NV 21860) | |
| 183500000X Pharmacist (Licence: IN 26028499A) | |
| 183500000X Pharmacist (Licence: VA 0202220840) | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |