| NPI | 1144837857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-15552) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000042402) |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2020-09-27 |