| NPI | 1356818447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0016127) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 26731) |
| Enumeration Date | 2018-10-27 |
| Last Update Date | 2018-10-27 |