| NPI | 1548538168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS21925) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 7482) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2011-12-09 |