| NPI | 1427368737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP444658) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 39198) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2016-05-16 |