| NPI | 1831403997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH023325) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 15751) |
| 183500000X Pharmacist (Licence: FL PS47069) | |
| Enumeration Date | 2010-08-01 |
| Last Update Date | 2011-08-16 |