| NPI | 1598989311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0014022) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00005882) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-10-23 |