| NPI | 1023248994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 02769) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: TN 02769) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2023-06-20 |