| NPI | 1023099009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD06048) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR 6048) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2020-05-07 |