| NPI | 1356678825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18022) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S009791) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |