| NPI | 1265719264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 043112) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 043122) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2023-06-08 |