| NPI | 1386307643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-01060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH238440) |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2021-10-14 |