| NPI | 1093037392 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 8430)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 042584)  | 
| Enumeration Date | 2010-02-28 | 
| Last Update Date | 2010-02-28 |