| NPI | 1891797684 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH-1194) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH38998) | 
| Enumeration Date | 2005-08-11 | 
| Last Update Date | 2007-07-08 |