| NPI | 1568063063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 017353) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26026283A) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |