| NPI | 1518517564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36240) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU8352) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |