| NPI | 1700180676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33575) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-010505) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-01-06 |