| NPI | 1568695435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 17020) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 8812) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2024-08-08 |