| NPI | 1427598838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2007023341) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 114339) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-03 |