| NPI | 1265831291 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0010379) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO PHA.0020548) | 
| 183500000X Pharmacist (Licence: NE 10862) | |
| 183500000X Pharmacist (Licence: MO 044260) | |
| Enumeration Date | 2014-08-14 | 
| Last Update Date | 2018-05-23 |