| NPI | 1710230941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 23921) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 10171) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |