| NPI | 1194000364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-14018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD12179) |
| 183500000X Pharmacist (Licence: AZ S015485) | |
| 183500000X Pharmacist (Licence: MO 2007031813) | |
| 183500000X Pharmacist (Licence: NE 13845) | |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2013-10-11 |