| NPI | 1215258314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 029091) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD05784) |
| Enumeration Date | 2010-06-13 |
| Last Update Date | 2010-06-13 |