| NPI | 1700011830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1847) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 18246) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |