| NPI | 1497359798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 23703) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3119) |
| Enumeration Date | 2020-11-26 |
| Last Update Date | 2020-11-26 |