| NPI | 1801230289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 13652) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22306) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-12-09 |