| NPI | 1417220955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IN 26015770A) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: IN 26015770A) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2019-12-06 |