| NPI | 1366043085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202219026) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 37991) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |