| NPI | 1942531868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PH.0021616) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM rp00007152) |
| 183500000X Pharmacist (Licence: AZ s016609) | |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2023-01-05 |