| NPI | 1700026895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP442067) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18798) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2009-03-02 |