| NPI | 1114202355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03129675) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26023459a) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |