| NPI | 1689032435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS56050) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 17195) |
| 183500000X Pharmacist (Licence: LA PST.021450) | |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2021-09-20 |