| NPI | 1588353726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202221177) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 31980) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-06-09 |