| NPI | 1467601450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302034753) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS43372) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2014-05-14 |