| NPI | 1851830566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2008028406) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps48540) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |