| NPI | 1437250958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 10000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 18386) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |