| NPI | 1578167086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 44242) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 21438) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2021-08-26 |