| NPI | 1083996219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3151) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA ph23950) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2011-09-14 |