| NPI | 1831106632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR 9309) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202205918) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2016-08-23 |