| NPI | 1962624676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3072) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 23274) |
| 183500000X Pharmacist (Licence: FL 37494) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-08-25 |