| NPI | 1649860040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD15102) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 28754) |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2024-02-20 |