| NPI | 1346584067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN inprogress) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps47243) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |