| NPI | 1710617121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S011432) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ i025585) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2023-04-06 |