| NPI | 1033657572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND RPh5115) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 119207) |
| Enumeration Date | 2017-02-04 |
| Last Update Date | 2017-02-04 |