| NPI | 1548597073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 16660) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS t-010025) |
| 183500000X Pharmacist (Licence: IL 051290631) | |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |