| NPI | 1891446787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 45141) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 020220426) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-06-15 |