| NPI | 1275901829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR pd10144) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 12798) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2023-07-05 |