| NPI | 1023714946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04365) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH236158) |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-16 |