| NPI | 1508587700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP457160) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA PI122242) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |