| NPI | 1851022487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 22680) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S025783) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |