| NPI | 1851991657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 10141) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 16997) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |