| NPI | 1043531270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000029778) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202208296) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |