| NPI | 1457722399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.020854) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 16616) |
| 183500000X Pharmacist (Licence: MS P010911) | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2022-12-06 |