| NPI | 1992129308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 33172) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ s007040) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2014-02-06 |