| NPI | 1457223844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH31537) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH31537) |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-09-23 |