| NPI | 1760979561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 021789) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 12113) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2022-12-22 |