| NPI | 1700151800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IN 26026039A) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: KY I10184) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2015-06-22 |