| NPI | 1306437256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 12168) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.014922) |
| 183500000X Pharmacist (Licence: MS T-14707) | |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-02-16 |