| NPI | 1649588237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.017020) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 17020) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2025-05-12 |