| NPI | 1013371186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.014855) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS T12456) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |