| NPI | 1922697291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD14162) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK R-18888) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-01-12 |