| NPI | 1235536541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0014438) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 55604) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |