| NPI | 1609694892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IN 26030487A) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY 023787) |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |