| NPI | 1649566746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR 9842) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2009014959) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2019-08-21 |