| NPI | 1538717632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000043251) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S024045) |
| Enumeration Date | 2019-09-01 |
| Last Update Date | 2019-09-01 |