| NPI | 1568931236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 246881) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 26199) |
| Enumeration Date | 2018-11-24 |
| Last Update Date | 2026-07-06 |