| NPI | 1386942795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 10654) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KS I-12125) |
| 183500000X Pharmacist (Licence: FL PS42126) | |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2011-03-09 |