| NPI | 1518288711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 32276) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH024061) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2023-04-28 |