| NPI | 1194927178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 10553) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: AL 10553) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2016-05-13 |