| NPI | 1023318656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 5463) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 13512) |
| 183500000X Pharmacist (Licence: MS 6972) | |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2010-10-29 |