| NPI | 1750650602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 22116) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 22067) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |