| NPI | 1851981070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 02020009976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 11130) |
| 183500000X Pharmacist (Licence: NC 15161) | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-01-21 |