| NPI | 1013109701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0014717) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS37634) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2025-09-02 |