| NPI | 1881895365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03127297) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26022157A) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-10 |