| NPI | 1801118500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS37563) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH22782) |
| 183500000X Pharmacist (Licence: AZ S011113) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |