| NPI | 1144620071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35629) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 227359) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2024-09-03 |