| NPI | 1144869728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000038257) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 13720) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |