| NPI | 1679906531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302047345) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202212475) |
| 183500000X Pharmacist (Licence: OR RPH-0017032) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2021-02-12 |