| NPI | 1407226566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 14031) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 025716) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |