| NPI | 1063828275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC PH-5795) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 144826-1701) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |