| NPI | 1689955882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 23769) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |