| NPI | 1497734354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS22684) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 19803) |
| 183500000X Pharmacist (Licence: FL PS 22684) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: FL PU 3626) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA 19803) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2014-09-30 |