| NPI | 1437421807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 49340) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 32686) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |