| NPI | 1598970022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 29361) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS52904) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-09-28 |