| NPI | 1184448219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302413986) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5315252283) |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |