| NPI | 1497162523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH3749) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202213108) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-07-21 |