| NPI | 1598242307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS54669) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 11991) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |