| NPI | 1891133625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03126659) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26019417A) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2013-06-14 |