| NPI | 1821363243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 36171) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21285) |
| 183500000X Pharmacist (Licence: LA 18863) | |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |