| NPI | 1629460795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY I10933) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26025518A) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |