| NPI | 1487735452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps 25675) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT CT10721) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-07-25 |