| NPI | 1942744206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 2510) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 22325) |
| 183500000X Pharmacist (Licence: PA RP-032854-R) | |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |