| NPI | 1255951471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0016745) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0022586) |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |