| NPI | 1831435825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 114367) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ND RPH4218) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |