| NPI | 1821270034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2005033292) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS 1-09508) |
| 183500000X Pharmacist (Licence: AR PD-10193) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |