| NPI | 1346500329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS40481) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU6305) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2021-02-22 |