| NPI | 1720446966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447010) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 36013) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |