| NPI | 1124236492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33634) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VI 231) |
| 183500000X Pharmacist (Licence: TX 57801) | |
| 183500000X Pharmacist (Licence: FL 54370) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2022-07-21 |