| NPI | 1265715494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 11798) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-09474) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |