| NPI | 1154758860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 5917009) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0013807) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2021-06-28 |