| NPI | 1598365181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH021017) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 10898) |
| 183500000X Pharmacist (Licence: KS 1-11943) | |
| Enumeration Date | 2020-10-31 |
| Last Update Date | 2020-10-31 |