| NPI | 1346583119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS45001) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS P12440) |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2013-03-31 |