| NPI | 1538441415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 008220) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 005173) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |