| NPI | 1891475281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 64131) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302413587) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-07-20 |