| NPI | 1104109958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03120993) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26017740a) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |