NPI | 1811612823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS61283) |
Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
Enumeration Date | 2022-10-11 |
Last Update Date | 2022-10-11 |