| NPI | 1760932693 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AR PD16031) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS55652) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2022-05-02 |