| NPI | 1902111743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S010535) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26021933A) |
| 183500000X Pharmacist (Licence: OH 03122846-1) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |