| NPI | 1457758781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 44660) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH027843) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2021-06-01 |