| NPI | 1447463724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 044593) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-12514) |
| 183500000X Pharmacist (Licence: AR PD11898) | |
| 183500000X Pharmacist (Licence: OK 15316) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-10-23 |