| NPI | 1104062132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202208333) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000034094) |
| 183500000X Pharmacist (Licence: GA 025333) | |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2022-12-08 |