| NPI | 1437429941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps38613) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS e09647) |
| Enumeration Date | 2012-01-01 |
| Last Update Date | 2016-03-17 |