| NPI | 1497405906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 70240) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS62235) |
| Enumeration Date | 2022-03-27 |
| Last Update Date | 2023-07-26 |