| NPI | 1902159700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 45923) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 6989777-1701) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2023-09-21 |