| NPI | 1841696358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N0905X Pharmacist Nuclear (Licence: CO PHA.0020331) |
| Additional Taxonomies | 1835N0905X Pharmacist Nuclear (Licence: MI 530204554) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |