| NPI | 1023349990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME R3010) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R0681) |
| 183500000X Pharmacist (Licence: IL 05128345) | |
| Enumeration Date | 2010-01-16 |
| Last Update Date | 2010-01-16 |