| NPI | 1194433029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 034779) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 19767) |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2025-06-11 |