| NPI | 1922368455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS24518) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S019033) |
| 183500000X Pharmacist (Licence: IL 051.037489) | |
| 183500000X Pharmacist (Licence: VA 0202210659) | |
| 183500000X Pharmacist (Licence: WI 12294-40) | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |