| NPI | 1497174072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 016973) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26026955A) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2020-11-03 |