| NPI | 1427673912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 43359) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 29171) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |