| NPI | 1407139892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IA 16072) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 013519) |
| 183500000X Pharmacist (Licence: IN 26091971A) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |