| NPI | 1700560927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 8202) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PR 2144) |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-12-20 |