| NPI | 1922860618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 22304-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 66583) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |