| NPI | 1841493699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 40365) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH023395) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2015-01-20 |