| NPI | 1659759272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 2319) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 6496548) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |