| NPI | 1750426359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps27220) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA rph016958) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-08 |