| NPI | 1396053799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202007401) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-06982) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2021-05-28 |