| NPI | 1942667175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS 14622) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS E-13592) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |