| NPI | 1225850647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302416621) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 60415) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |