| NPI | 1184239527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MT PHA-PHA-LIC-79743) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8870) |
| 3336N0007X Pharmacy, Nuclear Pharmacy | |
| Enumeration Date | 2020-09-12 |
| Last Update Date | 2024-04-02 |