| NPI | 1649240797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 40833) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 19912) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-07-08 |