| NPI | 1295195949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD12134) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007850) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |