| NPI | 1790234201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 011006) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26018203A) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |