| NPI | 1508172149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH-4188) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054962) |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2022-12-30 |