| NPI | 1033452511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202011112) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS29057) |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2013-04-02 |