| NPI | 1659500312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2011012782) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26023219A) |
| 183500000X Pharmacist (Licence: TX 49036) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2012-05-03 |