| NPI | 1144624867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 24047) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441035) |
| 183500000X Pharmacist (Licence: PA RPI003839) | |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2014-10-09 |