| NPI | 1710247143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302020067) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26011572A) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |