| NPI | 1033438262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 4551) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 15061) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2010-05-27 |