| NPI | 1437479706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 010643) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 16425) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |