| NPI | 1730851684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 125205) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH-4685) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2023-03-17 |