| NPI | 1437608510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1924) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH20547) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |