| NPI | 1518625748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202221676) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 29701) |
| 183500000X Pharmacist (Licence: DC PH200004908) | |
| 183500000X Pharmacist (Licence: MN 125459) | |
| Enumeration Date | 2021-12-05 |
| Last Update Date | 2025-08-21 |