| NPI | 1508926916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R0985) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 17063) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2025-09-11 |