| NPI | 1427291608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH009914) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 12439) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2016-10-26 |