| NPI | 1124628748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 015253) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0006344) |
| 183500000X Pharmacist (Licence: IN 26023748A) | |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2020-11-01 |