| NPI | 1801506043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-11824) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MS 16903) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2024-06-25 |