| NPI | 1801104104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 11167) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000011187) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2013-03-24 |