| NPI | 1538707062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO PHA.0022829) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302412076) |
| 183500000X Pharmacist (Licence: TN 43809) | |
| 183500000X Pharmacist (Licence: OR RPH-001758) | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |