| NPI | 1740410620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0017037) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MN 119735) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: MO 2011024490) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CT 11371) | |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2020-03-12 |