| NPI | 1437405339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NV 19889) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 14908) |
| 183500000X Pharmacist (Licence: IA 122481) | |
| 183500000X Pharmacist (Licence: FL PS53366) | |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2020-05-13 |