| NPI | 1386062529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 012567) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 12015) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |