| NPI | 1457738023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33682) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 19041) |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2015-05-02 |