| NPI | 1427464338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS25685) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU4000) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |