| NPI | 1467763839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 8806) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 35599) |
| 183500000X Pharmacist (Licence: NC 23170) | |
| 183500000X Pharmacist (Licence: VA 0202212679) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2015-08-24 |