| NPI | 1801141411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KS 1-17019) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD12018) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2016-06-15 |