| NPI | 1326533498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 70345) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS46643) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2026-04-09 |