| NPI | 1548865181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 67879) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 43250) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2021-09-03 |