| NPI | 1215578190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 20555) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0017474) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-11-09 |