| NPI | 1538639786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh5550) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 120806) |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-11-30 |