| NPI | 1033401724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T-010867) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 11907) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |