| NPI | 1871502153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0019207) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 10486) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-10-31 |