| NPI | 1821626532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 124485) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 6720) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2020-03-29 |