| NPI | 1629419643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 9776) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PS44631) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |