| NPI | 1831765064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 6884) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR70177) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2021-05-28 |