| NPI | 1932548765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 251.295671) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21649) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-06-14 |