| NPI | 1821781113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S023277) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 017803) |
| 183500000X Pharmacist (Licence: OH 03334886) | |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-06-01 |