| NPI | 1851398788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 27477) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 14780) |
| 183500000X Pharmacist (Licence: GA RPH022081) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-11-10 |