| NPI | 1285973982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 16942-40) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019623) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |