| NPI | 1366046716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD15222) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MO 045149) |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2024-01-25 |