| NPI | 1548690845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 16341) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 51035023) |
| 183500000X Pharmacist (Licence: WI 11091) | |
| 183500000X Pharmacist (Licence: AR PD11015) | |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2016-09-06 |