| NPI | 1962778506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI 2982) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ SO13696) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |