| NPI | 1487165122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 88598291701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26019282A) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 88598291701) | |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2017-10-21 |