| NPI | 1215531900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP045350R) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RPI004975) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2020-11-24 |