| NPI | 1699807115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist Geriatric (Licence: TN C-5302) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN C-5302) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2007-07-08 |