| NPI | 1649273863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS23697) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 23697) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-07-21 |