| NPI | 1326248311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ s026464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 15925) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2023-10-18 |