| NPI | 1922532233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PSI31422) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 68665) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2022-12-25 |