| NPI | 1932780103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP029588L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20046) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-04-19 |