| NPI | 1912280058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WI 14224-040) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26022525A) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2011-09-26 |