| NPI | 1487774287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 25001) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ph 16344) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-09 |