| NPI | 1841561438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 10396) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302031920) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |