| NPI | 1396517454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 41312) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202220854) |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |