| NPI | 1609189570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 28742) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 14284) |
| 183500000X Pharmacist (Licence: AL 12574) | |
| 183500000X Pharmacist (Licence: VA 0202208730) | |
| 183500000X Pharmacist (Licence: KY 7168) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-07-21 |