| NPI | 1033491659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH phcy-01136) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH21841) |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2021-12-13 |