| NPI | 1417542408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist Geriatric (Licence: IN 26017975A) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: OH 03334312) |
| 1835G0303X Pharmacist Geriatric (Licence: MI 5302043041) | |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2021-03-02 |