| NPI | 1841373925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ND 4451) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 115942-6) |
| 183500000X Pharmacist (Licence: SD 4696) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-02-14 |