| NPI | 1164199287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH033113) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH0331133) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2022-10-26 |