| NPI | 1578227807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61313046) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH-4657) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2022-10-02 |