| NPI | 1952681686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IN 26018073) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03-3-16930) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |