| NPI | 1598009938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 13210) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 14338) |
| 183500000X Pharmacist (Licence: MS 010668) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |