| NPI | 1487258695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 65627) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD15073) |
| 183500000X Pharmacist (Licence: FL PS61107) | |
| 183500000X Pharmacist (Licence: OK R-19015) | |
| Enumeration Date | 2020-11-28 |
| Last Update Date | 2020-11-28 |