| NPI | 1821449919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 6617221-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014364) |
| 183500000X Pharmacist (Licence: KS 1-15406) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-06-29 |