| NPI | 1902296064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 10667) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 14047) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |