| NPI | 1275915324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 18701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS53431) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2017-12-07 |