| NPI | 1841572666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp449440) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202207557) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2016-06-17 |