| NPI | 1164903837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 41295) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27623) |
| 183500000X Pharmacist (Licence: AL 20253) | |
| 183500000X Pharmacist (Licence: KY 019789) | |
| 183500000X Pharmacist (Licence: VA 0202216454) | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |