| NPI | 1194097758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 5707) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 16371) |
| Enumeration Date | 2012-01-29 |
| Last Update Date | 2012-01-29 |