| NPI | 1407121353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 60043) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ s016300) |
| 183500000X Pharmacist (Licence: HI PH-2689) | |
| Enumeration Date | 2012-03-11 |
| Last Update Date | 2012-03-11 |