| NPI | 1417579798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T-010898) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 13871) |
| Enumeration Date | 2020-05-10 |
| Last Update Date | 2020-05-10 |