| NPI | 1700169588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS e09029) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 28092) |
| 183500000X Pharmacist (Licence: FL ps33022) | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |