| NPI | 1639521644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 40166) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 26111) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2023-11-14 |