| NPI | 1780027318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 16387) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302039088) |
| 183500000X Pharmacist (Licence: CA 68442) | |
| Enumeration Date | 2013-04-13 |
| Last Update Date | 2013-04-13 |