| NPI | 1558033126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 15394) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 23260) |
| 183500000X Pharmacist (Licence: RI RPH06186) | |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |