| NPI | 1750722153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS15534) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PU2078) |
| Enumeration Date | 2013-07-13 |
| Last Update Date | 2013-07-13 |