| NPI | 1851264816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS T-102070) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH035548) |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-10-10 |