| NPI | 1093179988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH013124) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 09325) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2016-04-07 |