| NPI | 1497270961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps39004) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026651) |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-07-21 |