| NPI | 1538495619 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S006685)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26012769A)  | 
| Enumeration Date | 2009-10-26 | 
| Last Update Date | 2009-10-26 |