| NPI | 1346794641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 35687) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP032982L) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |