| NPI | 1326552100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 04367) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH PHCY-04367) | 
| 183500000X Pharmacist (Licence: NH 033.0134787) | |
| Enumeration Date | 2017-11-30 | 
| Last Update Date | 2024-05-16 |