| NPI | 1629580006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP454877) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26027242A) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2020-12-07 |