| NPI | 1396348744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI rph05653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH239158) |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-18 |