| NPI | 1780468066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 25009) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202216606) |
| 183500000X Pharmacist (Licence: GA RPH026566) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |