| NPI | 1295330413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-11897) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 20303) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |