| NPI | 1912225343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MS E-09330) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 33492) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2021-04-26 |