| NPI | 1831306950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 1375) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM 3663) |
| 183500000X Pharmacist (Licence: AZ 13032) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-07-16 |