| NPI | 1285966408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202005480) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 12027) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |