| NPI | 1245953926 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-110003) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2022036813) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |