| NPI | 1396977013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IN 26022538A) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15125-40) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2012-08-30 |