| NPI | 1851621387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP453083) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS43856) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2019-06-27 |