| NPI | 1649703679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 10129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL 18391) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-01-19 |