| NPI | 1568898310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH 10899) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00005716) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |