| NPI | 1346538741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202210698) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH026136) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-07-19 |