| NPI | 1396088274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 22214) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21848) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2013-03-29 |