| NPI | 1649511932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 14812) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-15044) |
| 183500000X Pharmacist (Licence: MO 2014035154) | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2024-08-22 |