| NPI | 1457631178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 10271) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 8719) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |