| NPI | 1497182901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 38758) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 23452) |
| Enumeration Date | 2013-09-28 |
| Last Update Date | 2020-11-17 |