| NPI | 1770965162 |
|---|---|
| Former Name | AHMAD ANDERSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST020776) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53433) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |