| NPI | 1023222163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 27461) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR 10314) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |