| NPI | 1427722867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-103880) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2021029655) |
| Enumeration Date | 2021-08-08 |
| Last Update Date | 2021-08-08 |