| NPI | 1477279669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202220435) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP455740) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |