| NPI | 1902401326 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-16623) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 0000044506) |
| 183500000X Pharmacist (Licence: CO PHA.0024007) | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2022-07-30 |