NPI | 1376363275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: PA RP458985) |
Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP458985) |
Enumeration Date | 2024-10-15 |
Last Update Date | 2025-08-20 |