| NPI | 1679599419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 37651) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P8142) |
| 183500000X Pharmacist (Licence: OR RPH-0011245) | |
| 183500000X Pharmacist (Licence: WA 62044) | |
| 183500000X Pharmacist (Licence: AZ 13453) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-06-10 |