| NPI | 1508072042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH-615) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 31536) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |