| NPI | 1376844779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 19482) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 1778) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2020-12-27 |