| NPI | 1417231499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33304) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA PST.010742) |
| 183500000X Pharmacist (Licence: GA RPH014924) | |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |