| NPI | 1457690075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS19202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL Ph19068) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |