| NPI | 1346845641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 29580) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD13660) |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2022-04-08 |