| NPI | 1033832654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T-12241) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 10996) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |