| NPI | 1942616123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 37383) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202212522) |
| 183500000X Pharmacist (Licence: NC 23828) | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |