| NPI | 1629348644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 34499) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |