| NPI | 1811140379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 29332) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH023709) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |