| NPI | 1174353163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 48245) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 024444) |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |