| NPI | 1891143129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK 119474) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 18316-40) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2017-10-19 |