| NPI | 1174812069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-07333) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 10915) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |