| NPI | 1003190315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0012637) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P6524) |
| 183500000X Pharmacist (Licence: MT 5302) | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |