| NPI | 1942532346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 22434) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP031198L) |
| 183500000X Pharmacist (Licence: MA PH17783) | |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2010-02-10 |