| NPI | 1790931335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0010344) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AK 1559) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |