| NPI | 1528571361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 43674) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS43674) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2018-05-22 |