| NPI | 1124327358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-03781) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 6160) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2011-03-28 |