| NPI | 1962376426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 69649) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PR 8264) |
| 183500000X Pharmacist (Licence: TN 47361) | |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |