| NPI | 1750636148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR 07430) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 12221) |
| 183500000X Pharmacist (Licence: TN 0000012221) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: TN 0000012221) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-07-20 |