| NPI | 1689761637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-15721) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 6911) |
| 183500000X Pharmacist (Licence: MI 5302036696) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2025-12-24 |