| NPI | 1851593693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 011956) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 05721) |
| 183500000X Pharmacist (Licence: KY 011143) | |
| 183500000X Pharmacist (Licence: NY 032438) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |