| NPI | 1821600784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 019770) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100002565) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |