| NPI | 1851698047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12728) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA rph024785) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-02-24 |