| NPI | 1518488717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0017828) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR P10012302) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-05-19 |