| NPI | 1699052829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 15225-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD13877) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2022-12-24 |