| NPI | 1588084305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI 04570) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 27416) |
| 183500000X Pharmacist (Licence: FL 48451) | |
| 183500000X Pharmacist (Licence: AZ S018790) | |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2014-04-19 |