| NPI | 1306493929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-12577) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS57692) |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |