| NPI | 1841754074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202215193) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100002574) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-02-06 |