| NPI | 1629560958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 33955) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 23779) |
| 183500000X Pharmacist (Licence: VA 0202212136) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |