| NPI | 1831219336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS43238) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PSI17968) |
| 183500000X Pharmacist (Licence: PA RP443524) | |
| 183500000X Pharmacist (Licence: FL PU7063) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-10-28 |