| NPI | 1417250101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0012482) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P6436) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2010-12-17 |