| NPI | 1225364896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 42236) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH-2165) |
| 183500000X Pharmacist (Licence: GA RPH023995) | |
| 183500000X Pharmacist (Licence: AR PD11854) | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2015-04-02 |