| NPI | 1144874223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0014806) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP453434) |
| Enumeration Date | 2019-07-28 |
| Last Update Date | 2019-07-28 |