| NPI | 1386002269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 41637) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 15859) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |