| NPI | 1316288277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0018397) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 52646) |
| 183500000X Pharmacist (Licence: FL PS48856) | |
| 183500000X Pharmacist (Licence: GA RPH028180) | |
| 183500000X Pharmacist (Licence: AZ S020305) | |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2021-10-13 |