| NPI | 1619124690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 26653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR PD10285) |
| 183500000X Pharmacist (Licence: TX 42179) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |