| NPI | 1952329229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T-09784) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 019490) |
| 183500000X Pharmacist (Licence: WV 5227) | |
| 183500000X Pharmacist (Licence: MT 4871) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |