| NPI | 1669714119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 2129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP441831) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |