| NPI | 1386964211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC NC20202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 20202) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2024-09-25 |