| NPI | 1972826311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33708) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 010555) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2015-08-06 |