| NPI | 1043586241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0006321) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 48618) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |