| NPI | 1326320326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 010220) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 29601) |
| 183500000X Pharmacist (Licence: SC 12221) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |