| NPI | 1477398568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 32548) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 43814) |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |