| NPI | 1477860476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6312248-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0012389) |
| Enumeration Date | 2010-09-12 |
| Last Update Date | 2022-07-26 |