| NPI | 1003241621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 36900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026902) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2013-09-13 |