| NPI | 1639770480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04530) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH239249) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |