| NPI | 1457833303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302041464) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0015652) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |