| NPI | 1063429710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 5866) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS33545) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-11 |