| NPI | 1124578042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 45074) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MI 5302040565) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2022-11-04 |