| NPI | 1184919128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 12044) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps36524) |
| 183500000X Pharmacist (Licence: WI 11550) | |
| 183500000X Pharmacist (Licence: GA rph025316) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-18 |