| NPI | 1336826841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 010541) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV 0013806) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-06-28 |