| NPI | 1003190497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 013034) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26019569A) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |