| NPI | 1538343819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND 5108) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SD 5501) |
| 183500000X Pharmacist (Licence: WY 3137) | |
| 183500000X Pharmacist (Licence: CO 17405) | |
| 183500000X Pharmacist (Licence: MT 6234) | |
| 183500000X Pharmacist (Licence: MN 119165) | |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2009-07-14 |