| NPI | 1598119554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-010347) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 39887) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |