| NPI | 1932483989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302025977) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS0023680) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |