| NPI | 1982028734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL 38760) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 16380) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |