| NPI | 1538056510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0010276) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03316081) |
| Enumeration Date | 2025-06-21 |
| Last Update Date | 2025-06-21 |