| NPI | 1932317203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 13753-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 13753-40) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2024-03-29 |