| NPI | 1851848378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS37463) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 015806) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |