| NPI | 1780972901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 015503) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26024145A) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2011-07-21 |