| NPI | 1346751757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0024351) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 2017029976) |
| 183500000X Pharmacist (Licence: OR RPH-0018529) | |
| 183500000X Pharmacist (Licence: KS 1-109234) | |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2023-09-13 |