| NPI | 1316050495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD09847) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR 09847) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-09-09 |