| NPI | 1457056061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS47012) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 19627) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |